“If you don’t stop being sick, you are going to have to go. I can’t take this anymore. We have done everything we can to help you get better but you just won’t help yourself. Your cancer has torn this family apart, and we just cannot do this anymore. You need to pack your stuff and get out. If you’re not going to stop having cancer and do something with your life, you are going to have to go. We love you but we are done.” That conversation sounds pretty ridiculous. No one suffering from cancer has heard that from a family member or a loved one, but each year thousands of people suffering from addiction hear this from their family and loved ones. With no other options, these individuals are many times forced to face their addiction alone, suffering not only from the disease that is controlling their life, but also from the shame and guilt associated with being an addict. In 1956 the American Medical Association identified addiction to alcohol as a disease, and in 1991 they took that definition even further: classifying addiction as both a psychiatric and a medical disease. In 2011 the American Society of Addiction Medicine followed that up with the following statement “addiction is a primary, chronic disease of the brain…characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with ones behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.” As understanding of addiction has improved it is disheartening that society’s misconceptions are still prevalent. Common sense tells one that chaining an addict to a tree to detoxify them (a common practice in the early 20th Century) is not an effective ‘treatment’, but too many people suffering from addiction are chained to the common belief that addiction is a weakness in willpower or a character flaw. Too many individuals miss out on treatment or lose their lives because of the stigma associated with addiction and treatment. In 1935 treatment for addiction began to change when Bill Wilson and Dr. Bob Smith, both recovering alcoholics, founded Alcoholics Anonymous (AA) in efforts to bring help to those who needed it. One of the key components to their mission was anonymity. Anonymity to protect the addict. What exactly do they need protecting from? Why does someone with a disease have to hide? The obvious answer is to protect an addict from the stigma associated with being an addict. There are too many cases of individuals losing their jobs, their careers, their families, and unfortunately their respectability because they suffer from a misunderstood disease. It’s obvious why anonymity is necessary but unfortunate that it is needed. Like most diseases, our understanding of addiction has increased drastically over the past 40 or 50 years. New technologies have allowed us to study the addict’s brain in ways never before dreamed possible. Neuroimaging has allowed us to see what is going on inside a drug addict’s brain whenever he or she has cravings to use, and we can even watch brain activity after an addict has used. All the new science continues to point to the seriousness of the disease of addiction. The sad reality of addiction is that success rate for long term sustained recovery is low. Addiction is a chronic debilitating disease that is a life long struggle for a drug addict. Given the stigma and misunderstanding of addiction, it is easy to see why addicts can lose hope about the future. The stigma of addiction even reaches into the recovery community, and certain stigmas exist among addicts. NA (Narcotics Anonymous) was founded in California in 1953 because Alcoholics Anonymous excluded individuals addicted to drugs, calling drug addiction “outside issues”. This stigma became evident in the late 1960’s and early 1970’s when methadone was first used to treat heroin addiction. Methadone is a synthetic opiate that is used to treat individuals suffering from addiction to opiates (heroin, morphine, and most prescription pain medications). Even within the recovery community, methadone maintenance is not seen as “true recovery”, but is often referred to as just trading one drug for another. Methadone maintenance, according to the National Institutes of Health, is the number one recommended treatment for opiate addiction and research shows it is the most effective. Unfortunately that doesn’t prevent clients receiving methadone treatment from being fired from jobs, told by family members they have to leave treatment, denied appropriate treatment through the court systems, refused treatment by doctors, refused mental health services, and even harassed by law enforcement. With the rising number of people addicted to pain medications and the reappearance of heroin in the drug community, it’s beyond time to reexamine outdated treatment concepts. The traditional abstinence based recovery models (AA, NA, inpatient treatment, outpatient group settings, etc.) have helped many individuals in their recovery from drug and alcohol addiction, however, with new understanding about the disease of addiction, the focus has to shift to individualized and appropriate treatment. I don’t think anyone would tell a cancer patient, “I don’t like chemotherapy, so you shouldn’t do it”. Look at another chronic, reoccurring, debilitating disease; diabetes. There are many people who have been able to manage their diabetes through proper nutrition and exercise. Others have had to take medication to get the diabetes under control, often times in conjunction with diet and exercise. And, unfortunately there are individuals who will have to wear an insulin pump the rest of their lives to manage their diabetes. Tell them “just lose weight and you will be fine.” Addiction is a disease for which there is no cure and no magic formula to make someone better. Addiction is a lifelong struggle against a disease that can and will kill. Unfortunately, the stigma of addiction adds to that struggle. Understanding the nature of the disease of addiction will go a long way towards accepting addiction as something other than a weakness of character. Drug addicts and alcoholics are not necessarily bad people; just like cancer patients and diabetics are not necessarily bad people. It’s time to end decades of backwards thinking, and recognize that addiction is a disease that cannot be cured, but can be treated, and that addict’s deserve the appropriate and most beneficial treatment available. It’s time to end the stigma.

September is National Recovery Month. A time to celebrate recovery. A time to recognize the hard work and dedication of so many individuals who have struggled with addiction and who are now living a life of sobriety and experiencing what many call “a normal life”. On the anniversary of one of our nation’s darkest days it would be easy to talk about how people who have hope can overcome any hardship, any setback, any dark day. It would be easy to say we should all celebrate hope, that any challenge can be overcome with dedication and hope. However, what I want to celebrate is the grandfather whose eyes light up when he talks about his granddaughter. I want to celebrate the young lady who has returned to school to get her GED. I want to celebrate 15 years sober with the professional who goes to work everyday. I want to celebrate the first negative drug screen. Celebrating relapse, because someone gains the strength to start back over at day one. Celebrating Hope – that’s easy! Celebrating Recovery – celebrating one day at a time, sometimes one hour at a time, that’s a different story. That is what I celebrate. I celebrate the strength to recognize that we are not perfect, that we will fail and that it is OK to have to start over. As we recognize National Recovery month, help me celebrate with that person who has one more day sober.